AB1134 IMPACT OF INFLAMMATORY BOWEL DISEASE ON DAPSA REMISSION IN PATIENTS WITH PSORIATIC ARTHRITIS: A PROPENSITY SCORE-MATCHED RETROSPECTIVE ANALYSIS OF “CROSS” MULTIDISCIPLINARY PROJECT PATIENTS’.
Authors: M. Giannotta, V. Venerito, L. Pacello, M. B. Principi, C. Foti, A. Di Leo, F. Iannone
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Psoriatic Arthritis (PsA) is a chronic inflammatory disease and patients with PsA have an increased risk of developing inflammatory bowel disease (IBD) [1]. It's not clear whether the coexistence of IBDs in PsA patients on bDMARDs is associated with the achievement of clinical outcome. <h3>Objectives</h3> The aim of this study was to identify whether IBDs may impact on 12-month remission of articular disease assessed by Disease Activity Index for Psoriatic Arthritis (DAPSA) in PsA patients on monoclonal anti-TNFα or anti-IL12/23 therapy. <h3>Methods</h3> Patients with classified PsA according to CASPAR criteria with active skin psoriasis who underwent monoclonal anti-TNFα or anti IL12/23 treatment were retrospectively analyzed from January 2019 to May 2021 in our CROSS multidisciplinary outpatient's clinic. Clinical and demographic characteristics as disease severity indices (Disease Activity in Psoriatic Arthritis (DAPSA), Psoriasis Area and severity index (PASI), and Leeds Enthesitis Index LEI) were recorded. We identified those with IBDs (either Chron's disease or Ulcerative Colitis) and assess the intestinal disease activity by specific symptoms (abdominal pain, diarrhoea, intestinal bleeding) or instrumental findings. Propensity score-nearest-neighbour (1:1; caliper= 0,2) algorithm was used to provide two comparable groups. Paired t-Test was used to identify differences between outcome of interest at different follow-up periods and univariate and multivariable logistic regression models were run to identify predictors of DAPSA remission at 12-month follow-up. <h3>Results</h3> Of 123 patients with PsA on monoclonal bDMARDs therapy, the algorithm retrieved a sample of 74 patients (IBD group 37 patients, control group 37 patients) matched by gender, BMI, age and DAPSA at bDMARDs start. In the PsA+IBD group mean age (± SD) was 55,21 ± 12,73, mean BMI was 27,70 ± 7,75, mean DAPSA was 17,28 ± 13,86, mean HAQ was 0,90 ± 0,74 and mean PASI was 1,13 ± 2,99. In PsA-only group mean age was 47,19 ± 10,23, mean BMI was 27,24 ± 5,10, mean DAPSA was 20,21 ± 12,58, mean HAQ was 0,92 ± 0,77 and mean PASI was 0,94 ± 2,25. The final multivariate model included DAPSA at baseline (OR 0,89 95% CI 0,82-0,97), duration of joint involvement (months, OR 0,99 95% CI, 0,98-0,99), HAQ (OR 0,66 95% CI 0,22-1,93) and presence/absence of IBD. HAQ was retained in the model as a potential confounder. PsA-only patients were more likely to achieve DAPSA remission at 12 month-follow up (OR=7,37; 95% CI 1,58-34,37). <h3>Conclusion</h3> In the management of PsA patients with IBD undergoing monoclonal anti-TNFα or anti-IL12/23 therapy, intestinal involvement has a negative influence on the clinical response of articular disease. For these patients clinicians should consider a low DAPSA at baseline and a shorter PsA disease duration as a predictor of 12-month DAPSA remission. <h3>Reference</h3> [1]Li WQ, Han JL, Chan AT, et al. Psoriasis, psoriatic arthritis and increased risk of incident Crohn's disease in US women. Ann Rheum Dis 2013. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> maria giannotta Speakers bureau: yes, Vincenzo Venerito: None declared, lucia pacello: None declared, maria beatrice principi: None declared, caterina foti: None declared, alfredo di leo: None declared, Florenzo Iannone: None declared.